Stage 1 TNBC underwent surgery ,chemo now advised radiation to curb local residual cancer cells .This they say is protocol for ,what is known as BCT .I am speaking of my wife.

However ,tricky part is that neither Oncologist ,nor Oncosurgeon ,nor any nurse told us the hazards associated with radiation .Now Radiation Oncologist explains us that there is definite risk of what is called as coronary events in coming future ,right from 5 yrs after radiation treatment.He also explained that the ways to reduce the risks are there but still there is definite risk in future life that she might get cardiac problems and this is over and above the risks of age related cardiac problems.

I don't understand why it is not explained outright at the time of pre surgical counselling?

Is it standard practice all over world not to explain about radiation hazards at the time of surgery itself ?

BCT is nowadays promoted as main choice to all the women irrespective of age.I came across many patients during tenure of surgical stay and chemo .So i can tell you this with confidence.

there is Risk from Surgery, Risk from Anaesthesia, Risk from Chemotherapy.

Standard International Practice, is that a surgeon would offer you the option of Mastectomy Vs breast conservation Treatment (The latter whenever done would come with package of Additional Adjuvant Radiation always). The outcomes of patients having Mastectomy Vs Breast conservation are absolutely the same.. No difference in survival.

With BCT, there are obvious benefits of preserving the Breast and tons of articles on its benefit in the physical, psychological, social and mental health of women in terms of preserving body image, social interactions.

The surgeon would not be expected to tell you the side effects of Chemotherapy, and similarly he would not be expected to have a Radiation Oncology Consultation and tell you all the details about this procedure, benefits, side-effects etc...he would best be suited to discuss the surgical complications of infections, bleeding, seroma, lymphedema, etc.

Coming to Radiotherapy:

The benefits far outweigh the risks involved. From the most modern UK Start Trial, where modern approach CT scan based Radiation Planning is adopted, we would routinely quote 1.5-1.8 % chance of having an Ischemic Heart Event at 10 years. Out of the 4451 women in the trial, 73 women had such an unfortunate event (1.64%)

I m sure your Radiation Oncologist will make all the efforts at ensuring the cardiac mean dose is kept to a minimum, and he is legally obliged to inform you about the possible cardiac side-effects at 5 or 10 or later years. Honesty does make a difference.

All the very Best to your wife !

Hope your wife is in the 98.36% of women who does not have any Ischemic Heart Event.